Monday, May 5, 2014

Joe Klein – Exasperating “Mediscare” Idiot

Joe Klein is nothing if not predictable. In his latest column ‘Return to Mediscare’  (TIME, April 28, p. 25) he castigates both parties for running ads trying to scare the bejeezus out of seniors in the run-up to the November mid-terms. For Repukes, it’s a chance to once more seek to undermine the Affordable Care Act, while for the Dems in assorted locales, it’s a useful cudgel to go after Repub opponents.

Klein cites Arkansas as a case in point where Dem moderate Mark Pryor is using a woman named “Linda” to warn of his opponent Tom Cotton’s plans to wreck Medicare. The “Linda” ad states that “Tom Cotton voted to turn Medicare into a voucher system”.

Klein then asks" 'Is this accurate?', then replies, “Well yes and no” and classifies it as a “brilliant Mediscare ad.” In qualifying his answer he goes on to write:

Cotton and 218 of his House colleagues in the House did indeed vote for the Paul Ryan budget, which would slash costs by moving to a privatized (‘premium support’) or voucher system of health care for senior citizens. Is this a bad idea? Probably not.”

Is this guy mad, or just suffering from every day delusions? Of course it’s BAD!

 Let us bear in mind here the maximum "premium support" ever suggested for this absurd program has been $15,000/yr. But the current average senior in Medicare requires support (or if you want, assistance) in the vicinity of $30,000/yr and much more post-86 years of age. This means that at the level of only $1,250 a month, most seniors - unless spectacularly healthy - won't get much help.

Let us assume an elderly woman requires hip replacement surgery at an on-paper cost of $30,000 somewhere in FLA. Today, Medicare - standard Medicare, will pay 80% of that or $24,000, leaving her with $6,000 to pay on her own. A goodly amount,  but not insuperable or break the bank. In premium support at the maximum level, however, the woman would use ALL her allotment for one operation and still have $15,000 left to pay, and no more "premium support" for any other needs that may arise.

In the case of my prostate cancer radiation treatment 2 years ago, “premium support” would have covered $15,000 at most – leaving me with over $35,000 to cover on my own for just the basic high dose radiation treatment. In addition, I’d not have been able to use any further “support” money for any other problems that arose.

 Is Klein this ignorant, or is he just plain stupid?

Economics Professor Fiona Scott Morton (The Market Can’t Cure Medicare’, May 2, 2011) observed that  indeed any such premium support plan, is merely a demand shedding plan. As she puts it, “there’s no evidence many companies will be rushing in to provide health coverage to ailing boomers with competition that ought to lower any premiums"


She added:

"The Republican plan is not solving the problem. It’s solving the problem of the cost of government health care. You have people who can’t afford it and they’ll just die. Economists call that demand shedding”.

Klein then actually compounds his ignorance or stupidity by blabbering:

“”In fact, a more generous version already exists in the form of Medicare Advantage, the private sector Medicare alternative that seems to be going great guns in the Obamacare era.”

But he’s mixing chalk and green cheese. There’s actually no comparison since Medicare Advantage is actually MORE generous than standard Medicare (which the Neolibs keep yapping about cutting).

 Under traditional Medicare the coinsurance is pegged at 20%, but the actual amount out of pocket can be higher since specialists generally charge more for services.  This is not the case for the private Medicare Advantage plans for which the payout limits are often under 20% for special services, because the premiums from standard Medicare beneficiaries are used to subsidize higher specialist and other costs.

This is exactly why, in previous reports, the GAO has reported that the cost -burden of Medicare Advantage plans has added up to $12 BILLION a year to the cost for traditional Medicare and why the latter's headed toward insolvency. Of course! Because the Advantage plans are like parasites bleeding it down! Does Joe Klein mention any of this? Of course not!

The point is the Advantage plans are required to offer a benefit “package” that is at least as good as Medicare's and cover everything Medicare covers, but  usually they offer much more!  Plans that require higher out-of-pocket costs than Medicare for some benefits, like skilled nursing facility care, can balance their benefits package by offering lower copayments for doctor visits, plus use some of the excess payments they receive from the government for each enrollee to offer supplemental benefits.

But this in NO way is similar to Ryan's voucher ("premium support") plan which would offer a single fixed voucher in a designated amount (e.g. $10,000) - from the government - to have to go out and actively snag a private plan (hoping it will accept the senior)  and the limits of the voucher to cover future costs of visits, care over the year. By contrast, once a senior chooses a private plan in the sphere of Medicare Advantage there are no 'ifs, ands, or buts' - he will be allocated a  private plan and can't be denied for pre-existing conditions or any other balderdash.  The private insurers also know it's a good deal for them since they're assured of regular monthly payments from the gov't which have the potential of increasing each year! No fixed, one time, voucher pays!

Another goodie for the Medicare Advantage senior: Advantage plans typically do not contain deductibles, thereby giving members "first-dollar" coverage. (Original Medicare has a potentially recurring (more than once per calendar year) deductible for Part A and an annual deductible for Part B.) Ryan's plan by contrast will likely see private health insurers attaching massive deductibles, on the order of $3,000 -$5,000 or more, for the simple reason that the insurers will be having to take chances (with no regularly promised gov't subsidies, only the single voucher payment) with a person in a putative high risk health pool! It doesn't take a genius to see that with such deductibles in play, and assuming the private insurer even accepts the senior, much of the voucher will be eaten up before the first real care is even delivered.

The sad fact here? Klein actually has the freaking nerve to assume (and entice his readers to believe)  that Ryan’s premium support voucher plan is little different from Medicare Advantage and would not be different if the Repukes ever got to implement it.  The Pryor ad which he castigates as “Mediscare” by contrast, is realistic enough to grasp that would no more transpire than aliens landing from Tau Ceti landing and abducting the whole GOP House.

What can we conclude? That the Mark Pryor ad is spot on in its perceptions, and that Klein’s bullshit is not to be trusted. But then, no Neolib hack’s is, whether Klein, Robert Samuelson or any other puppets.

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